Department of Medicine, Federal University of São Paulo, São Paulo, Brazil.
Department of Microbiology, Immunology and Parasitology, Federal University of São Paulo, São Paulo, Brazil.
PLoS One. 2014 Jan 3;9(1):e84066. doi: 10.1371/journal.pone.0084066. eCollection 2014.
The present study investigated the prevalence of HIV-1 multiple infections in a population composed by 47 patients under HAART failure and enrolled at the National DST/AIDS, Program, Ministry of Health, Brazil.Detection of multiple infections was done using a previously published RFLP assay for the HIV-1 protease gene, which is able of distinguishing between infections caused by a single or multiple HIV-1 subtypes. Samples with multiple infections were cloned, and sequence data submitted to phylogenetic analysis. We were able to identify 17 HIV-1 multiple infections out of 47 samples. Multiple infections were mostly composed by a mixture of recombinant viruses (94%), with only one case in which protease gene pure subtypes B and F were recovered. This is the first study that reports the prevalence of multiple infections and intersubtype recombinants in a population undergoing HAART in Brazil. Based on the data there was a steep increase of multiple infections after the introduction of the combined antiretroviral therapy in Brazil. Cases of multiple infections may be associated with HIV-1 genetic diversity through recombination allowing for the generation of viruses showing a combination of resistance mutations.
本研究调查了在巴西卫生部国家艾滋病和性传播疾病防治计划中，47 名抗逆转录病毒治疗失败的患者人群中 HIV-1 多重感染的流行情况。使用先前发表的 HIV-1 蛋白酶基因 RFLP 分析方法检测多重感染，该方法能够区分由单一或多种 HIV-1 亚型引起的感染。对存在多重感染的样本进行克隆，并将序列数据提交给系统发生分析。我们在 47 个样本中鉴定出 17 种 HIV-1 多重感染。多重感染主要由重组病毒混合组成（94%），仅有一种情况同时回收了 HIV-1 亚型 B 和 F 的纯蛋白酶基因。这是巴西接受抗逆转录病毒治疗的人群中首次报告多重感染和亚型内重组的流行情况。根据数据，巴西联合抗逆转录病毒治疗引入后，多重感染的发生率急剧上升。多重感染可能与 HIV-1 遗传多样性通过重组有关，从而产生具有耐药突变组合的病毒。
